Healthcare Provider Details

I. General information

NPI: 1902920689
Provider Name (Legal Business Name): GERARD A. BEGLEY DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2007
Last Update Date: 01/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

385 STATE RT. 24 STE 3B
CHESTER NJ
07930
US

IV. Provider business mailing address

385 STATE ROUTE 24 STE 3B
CHESTER NJ
07930-2918
US

V. Phone/Fax

Practice location:
  • Phone: 908-879-8339
  • Fax:
Mailing address:
  • Phone: 908-879-8339
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number17366
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: